Physician acceptance of direct primary care (DPC), a practice model that does not accept health insurance and bills members a monthly membership fee, is on the rise according to the 2016 Great American Physician (GAP) Survey. While only 5 percent of responding physicians said they were currently in a DPC practice, 62 percent said they would consider switching to the model if the circumstances were favorable, which is a 44 percent increase over the 2015 GAP survey.
Clint Flanagan is a family medicine and emergency medicine physician who has practiced in Colorado for 15 years. He is also founder and CEO of Nextera Healthcare, a DPC organization with clinics throughout Boulder, Longmont, and Ft. Collins, Colo. Physicians Practice recently spoke with Flanagan about the advantages of practicing in a DPC practice model in anticipation of his presentation at the Medical Group Management Association (MGMA) 2016 Conference, Tuesday, Nov. 1, at 1:30 pm Pacific time.
Physicians Practice: Why did you change your practice model to direct primary care?
Clint Flanagan, MD: I had been doing fee-for-service (FFS) primary care for many years, as well as working as an emergency room physician. And through all that experience, I just saw so many patients having barriers to access to their primary-care provider. And often times cost is a big issue. There were many patients that had lost jobs, [and] patients that were now on high deductible health plans and were concerned about what the cost would be to visit the physician. And having seen many of those challenges, I really felt there needed to be a solution that would allow for that physician-patient relationship to essentially be revitalized in a way that was different than what was happening.
This was back in 2009. We essentially landed on a monthly membership [DPC model] and at the time we didn't even know what DPC was. But I knew that we needed to [transition to] monthly membership primary care and charge a very affordable fee. We like to say "If you can afford a cell phone, you can afford what we do in DPC." And that fee would allow patients to have access to their family medicine physician and have a relationship. By no means were we innovative on that front, in fact we were pretty old fashioned in that we just felt that it was important that patients have that connectivity and trust and relationship [with their physician], and do so in a way that didn't have barriers [like] the other business models ...
PP: How does DPC benefit physicians?
CF: [DPC] frees up the physician to have longer visits, for example. So I used to be a physician who saw 30 patients a day. And do a lot of, I call it pecking for payment on our computers, [entering data from the patient visit into the EHR]. Unfortunately as we are pecking for payment we are taking away from the most important thing and that is our patient. And that data entry requires a lot of time. Fortunately, DPC is a model where there's a medical record which is very important to make sure that you document the visit, but you don't have to do all the other details that are required or oftentimes needed in the FFS model. Plus it streamlines things.